Clinical - Page 3

Data suggests that the interventions put in place to control the pandemic may have reduced the childhood population’s resistance to normal endemic diseases leading to a ‘build-up of susceptibility’. Roshni Mistry and James Hibberd warn us to be prepared for a possible

The good news is that palliative care is reaching more people with cancer, organ failure and frailty and dementia, and is starting earlier. But Scott Murray and Jordi Amblas question why planned and emergency medical care continues to expand even more for

Severe combined immunodeficiency (SCID) affects approximately 14 infants a year in England. The condition is usually fatal by 12-18 months of age without bone marrow transplantation. Public Health England will be performing a two year evaluation of newborn screening for SCID in

The UK Government announced its intention to introduce a national system of medical examiners in England which will result in the scrutiny of all deaths not referred to the coroner. Frances Cranfield explains what we need to know.

From this year GP registrars will be spending two years of their training in the community. Rachel Roberts and her colleagues share their findings from a pilot scheme.

GPDPR is a new initiative from NHS Digital to collect data held in GP medical records, to be available to third parties for research and planning. Unlike most other projects, patients have to actively opt out if they do not want their

Most of those who die by suicide contact primary care in the year or months prior to the suicide. GPs are a trusted and valued source for help-seeking among those who are at-risk of suicide. So how can we help? Maria Michail

Most children removed from their birth family have experienced multiple traumas. Hannah Milton finds that when talking to patients about anxiety, depression, addiction, relationship problems and difficulties with their own children’s behaviour, one her most useful history taking techniques is a simple

Preventing ill health requires an emphasis on the behaviours. Changing patient behaviour can take years and necessitates sustained resources. Vasumathy Sivarajasingam introduces us to the basics of motivational interviewing.

Advance care planning conversations for people likely to be in the last year of life are often not easy. Charles Daniels offers us “the 4 W’s + 1” - a straightforward tool for having difficult advance care planning discussions.

Not many of us expect to be working for the NHS for 50 years. Zarmina Rayaz reports on a remarkable colleague, and tells us what what keeps him going.

The "Defeat Depression" campaign of the 1990s told us that anxiety and depression were caused by a “chemical imbalance in the brain”, and that SSRIs were safe, effective and non-addictive. We now know that virtually every part of that narrative is untrue.

We cannot prevent dying, but we can certainly prevent much unnecessary suffering and overtreatment. Scott Murray shows us how we can incorporate "Anticipatory Care" into the ordinary GP consultation.

After experiencing severe antidepressant withdrawal in 2017, Edward White writes on the failure of healthcare services to recognise symptoms of, and correctly diagnose, antidepressant withdrawal, causing many to turn from primary care to antidepressant withdrawal Facebook groups.

As GPs we know a lot about recurrent urinary tract infections. James Malone-Lee is Emeritus Professor of Medicine, University College London. His research suggests that most of what we think we know is wrong. Here he explains the evidence.

Vasumathy Sivarajasingam describes how we can proactively identify and support victims of domestic abuse.

"I ask them - but I'm not asking them in a way that invites a 'yes'" - It can be difficult to broach the subject of self-harm or suicidal thoughts during a consultation. After altering her practice since reading Ford et al's

With the incidence rate of coeliac disease in the UK increasing four-fold between 1990 and 2011, it is essential that patients with coeliac disease continue to receive appropriate support and management during the COVID-19 pandemic. Here, Yvonne Jeanes et al. outline how

Half of patients with elevated blood sugars, with an HbA1c greater than 42, are not clinically obese. As well as the usual measures Sarah Blake asks whether we need to pay more attention to post prandial blood sugar spikes - is it

People living with severe and prolonged mental illness in England die 15-20 years earlier than the general population. Richard Armitage alerts us to the fact that there has been a marked decrease in the proportion of such patients who have had a

How should antipsychotic medication be reviewed when patients no longer have access to a psychiatrist? In the UK, little guidance is available. Lisa Grünwald and her colleagues are reflecting on the issues and asking for our help.

Chronic primary pain is a relatively new concept. Ensuring its definition is consistent within new guidelines is key. Here, members of the National Advisory Committee for Chronic Pain provide a number of observations on the use of drugs in chronic pain management,

Safety netting is essentrial in primary care but there is no one accepted definition. Peter Lindsay fixes this for us!

Doctors are not strangers to adversity, both in the lives of our patients and sometimes in our own. Judith Dawson examins two inspirational accounts to tell us how we can practically help.

Hypersensitivity pneumonitis is a form of interstitial lung disease caused by the repeated exposure and immune sensitisation to organic dusts and certain industrial agents. The circumstances of lockdown may increase the exposure of the public — and waste management workers in particular

Contextual safeguarding is a relatively new concept, which is primarily intended for adolescents. Recognising that young people are often exploited and abused outside their family environment, contextual safeguarding focuses on influencing and shaping those areas.

Rosie Marshall is a GP based in Wiltshire.  General practice routinely involves supporting patients presenting with diverse manifestations of stress. This can be a challenging issue for clinicians to manage because by definition there are underlying circumstances (sometimes related to complex and

Ahmeda Ali is a GP in Ireland. Ahmeda’s essay was one of the Sheppard Memorial Prize winners at the Republic of Ireland Faculty Winter Meeting. An abridged version will be published in the BJGP and here we present the full essay with

Pain, Opioids and Syringe Drivers: A Practical Guide for the GP in the Wake of Gosport This article is written by Daniel Knights, Felicity Knights and Stephen Barclay and is published as a companion piece to their editorial in the October 2018 issue of the BJGP. The

Shona Lucitt (right) is currently studying for a Masters in Public Health at Imperial College London. She previously worked at the Alzheimer’s Society supporting a pilot project for people living with YOD. More recently she has been working for Public Health England in

Peter Lucassen has been working as a GP for 35 years in a small village in the Netherlands and has just retired. He is still working as a senior researcher at Radboud University Nijmegen Medical Centre. He is interested in medically unexplained